Md Mizanur Rahman1, Sarah Krull Abe2, Md Shafiur Rahman2, Mikiko Kanda2, Saki Narita2, Ver Bilano2, Erika Ota3, Stuart Gilmour2, Kenji Shibuya2. 1. Department of Global Health Policy, The University of Tokyo, Tokyo, Japan; Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh; and mizanur_rub@yahoo.com. 2. Department of Global Health Policy, The University of Tokyo, Tokyo, Japan; 3. Department of Health Policy, National Centre for Child Health and Development, Tokyo, Japan.
Abstract
BACKGROUND: Anemia is a leading cause of maternal deaths and adverse pregnancy outcomes in developing countries. OBJECTIVES: We conducted a systematic review and meta-analysis to estimate the pooled prevalence of anemia, the association between maternal anemia and pregnancy outcomes, and the population-attributable fraction (PAF) of these outcomes that are due to anemia in low- and middle-income countries. DESIGN: PubMed, EMBASE, CINAHL, and the British Nursing Index were searched from inception to May 2015 to identify cohort studies of the association between maternal anemia and pregnancy outcomes. The anemic group was defined as having hemoglobin concentrations <10 or <11 g/dL or hematocrit values <33% or <34% depending on the study. A metaregression and stratified analysis were performed to assess the effects of study and participant characteristics on adverse pregnancy risk. The pooled prevalence of anemia in pregnant women by region and country-income category was calculated with the use of a random-effects meta-analysis. RESULTS: Of 8182 articles reviewed, 29 studies were included in the systematic review, and 26 studies were included in the meta-analysis. Overall, 42.7% (95% CI: 37.0%, 48.4%) of women experienced anemia during pregnancy in low- and middle-income countries. There were significantly higher risks of low birth weight (RR: 1.31; 95% CI: 1.13, 1.51), preterm birth (RR: 1.63; 95% CI: 1.33, 2.01), perinatal mortality (RR: 1.51; 95% CI: 1.30, 1.76), and neonatal mortality (RR: 2.72; 95% CI: 1.19, 6.25) in pregnant women with anemia. South Asian, African, and low-income countries had a higher pooled anemia prevalence than did other Asian and upper-middle-income countries. Overall, in low- and middle-income countries, 12% of low birth weight, 19% of preterm births, and 18% of perinatal mortality were attributable to maternal anemia. The proportion of adverse pregnancy outcomes attributable to anemia was higher in low-income countries and in the South Asian region. CONCLUSION: Maternal anemia remains a significant health problem in low- and middle-income countries.
BACKGROUND:Anemia is a leading cause of maternal deaths and adverse pregnancy outcomes in developing countries. OBJECTIVES: We conducted a systematic review and meta-analysis to estimate the pooled prevalence of anemia, the association between maternal anemia and pregnancy outcomes, and the population-attributable fraction (PAF) of these outcomes that are due to anemia in low- and middle-income countries. DESIGN: PubMed, EMBASE, CINAHL, and the British Nursing Index were searched from inception to May 2015 to identify cohort studies of the association between maternal anemia and pregnancy outcomes. The anemic group was defined as having hemoglobin concentrations <10 or <11 g/dL or hematocrit values <33% or <34% depending on the study. A metaregression and stratified analysis were performed to assess the effects of study and participant characteristics on adverse pregnancy risk. The pooled prevalence of anemia in pregnant women by region and country-income category was calculated with the use of a random-effects meta-analysis. RESULTS: Of 8182 articles reviewed, 29 studies were included in the systematic review, and 26 studies were included in the meta-analysis. Overall, 42.7% (95% CI: 37.0%, 48.4%) of women experienced anemia during pregnancy in low- and middle-income countries. There were significantly higher risks of low birth weight (RR: 1.31; 95% CI: 1.13, 1.51), preterm birth (RR: 1.63; 95% CI: 1.33, 2.01), perinatal mortality (RR: 1.51; 95% CI: 1.30, 1.76), and neonatal mortality (RR: 2.72; 95% CI: 1.19, 6.25) in pregnant women with anemia. South Asian, African, and low-income countries had a higher pooled anemia prevalence than did other Asian and upper-middle-income countries. Overall, in low- and middle-income countries, 12% of low birth weight, 19% of preterm births, and 18% of perinatal mortality were attributable to maternal anemia. The proportion of adverse pregnancy outcomes attributable to anemia was higher in low-income countries and in the South Asian region. CONCLUSION:Maternal anemia remains a significant health problem in low- and middle-income countries.
Authors: Nir Melamed; Ahmet Baschat; Yoav Yinon; Apostolos Athanasiadis; Federico Mecacci; Francesc Figueras; Vincenzo Berghella; Amala Nazareth; Muna Tahlak; H David McIntyre; Fabrício Da Silva Costa; Anne B Kihara; Eran Hadar; Fionnuala McAuliffe; Mark Hanson; Ronald C Ma; Rachel Gooden; Eyal Sheiner; Anil Kapur; Hema Divakar; Diogo Ayres-de-Campos; Liran Hiersch; Liona C Poon; John Kingdom; Roberto Romero; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-03 Impact factor: 3.561
Authors: Alexandra Jablonka; Martin Wetzke; Georgios Sogkas; Christian Dopfer; Reinhold Ernst Schmidt; Georg M N Behrens; Christine Happle Journal: J Immigr Minor Health Date: 2018-12
Authors: O Pasha; E M McClure; S Saleem; S S Tikmani; A Lokangaka; A Tshefu; C L Bose; M Bauserman; M Mwenechanya; E Chomba; W A Carlo; A L Garces; L Figueroa; K M Hambidge; N F Krebs; S Goudar; B S Kodkany; S Dhaded; R J Derman; A Patel; P L Hibberd; F Esamai; C Tenge; E A Liechty; J L Moore; D D Wallace; M Koso-Thomas; M Miodovnik; R L Goldenberg Journal: BJOG Date: 2018-05-21 Impact factor: 6.531